LEIOMYOSARCOMA OF THE UPPER LIP

A 90-year-old woman was seen for a tumor on the upper lip that had bee n present for 2 years. The lesion measured 6 x 4 cm and affected the e ntire upper lip. The tumor was dark red in color, and the surface was ulcerated and vegetating (Fig. 1). The general condition of the patien t was good. There was no lymphadenopathy. Histopathologic examination revealed a proliferation of fusiform cells in interlacing bundles (Fig . 2). The cytoplasm was eosinophilic and occasionally fibrillar. The n uclei were elongated with rounded ends (cigar-shaped) (Fig. 3). Pleomo rphism was moderate, with a number of different nuclear convolutions ( curves of the nucleus) and prominent nucleoli. Immunohistochemistry re vealed positive reactions to muscle-specific actin (HHF35) and vimenti ne (V9), but negative reaction to desmine (DER-11), broad spectrum cyt okeratins (AE 1/AE 3), and S100 protein. These histopathologic and imm unohistochemical results led to the diagnosis of leiomyosarcoma. Chest x-rays and computer-assisted tomography and echography of the abdomen were normal. The skin lesion was surgically removed and the patient d ied in the late postoperative period.